| NPI | 1710695796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP026509) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ14901400) |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2024-03-11 |